Title: Culture and psychopathology-Mental Illness in a Cross-Cultural Perspective
Keywords: Mobility / migration
Mental health problems
Behavioral aspects (in gen.)
Anthropology
Country: Norway
Institution: Norway - Centre for International Health, Universitetet i Bergen
Course coordinator: David Lackland Sam
Date start: 2020-03-30
Date end: 2020-04-03
About duration and dates: 30.03.-3.04.2020 (face to face) + one preparatory week and one week to work on assignment (student investment time; not necessary to be in Bergen)
Classification: advanced optional
Mode of delivery: Face to face
Course location: Centre for International Health
University of Bergen
P.O. Box 7804
N-5009 Bergen
Norway
ECTS credit points: 4 ECTS credits
SIT: TOTAL SIT = 110 hours (comprising of)
• 40 of preparatory reading
• 20 hours group work
• 20 hours group work
• 30 hours individual assignment
Language: English
Description:
This is a 3 week course, and this is how the 3 weeks are distributed:

1. week reading before the start of the course (which will include an interview assignment with a report)

1. week face-to-face teaching plus presentations and discussions

1. week self-study of chosen topic (to be assessed based on a written report)
Focus or specific features:
At the end of the course, the student should be able to
• Identify which aspects of mental illness symptomatology that are cultural general, and which aspects are cultural specific

• Develop hypothesis on the aetiology of different forms of mental illness

• Utilize the acquired knowledge to appraise differential prevalence, expression, course and prognosis of mental illness across cultures

• Transform the knowledge into cultural competence and be able to promote culturally sensitive mental health care in various cultural societies, and/for different ethnic groups
Assessment Procedures:
Continuous assessments involving 3 short essays (up to 500 words) and 2 long essays (up to 2500 words) essays to be written at home.
The marks will be distributed as 30% (for short essays) and 50% (for long essays). There will also be a group presentation, where participation is obligatory and will carry 20% of the final grade
Submitted essays will be check for plagiarism
The preparatory reading will conclude with interviewing an individual who comes from a different society (than yours), on the topic – what is considered “mental illness” or “being mad” in that society?”. A report based on this interview is to be submitted at the start of the course.
The assessment of
(i) this essay will be based on “the quality of the interview”
(ii) the extent the interviewer manages to tease out indigenous meaning of “madness”
Content:
Like all systems of healing, biomedicine is a cultural product arising from Western industrialised countries. Yet practice of medicine to a large extent has shown very little cognisance to cultural and social factors that affect people’s health. Biomedical conception of health and its practice are often transported from one part of the world to the other in packages of “absolute truths”. Notwithstanding great results, they have sometimes proven to be ineffective and even detrimental to the receiving group of people. Central to this problem is failure on the part of biomedicine to take into account culture's influence on people's attitudes, belief systems, conception of illness and disease, disease aetiology, and health-care seeking behaviour. In addition, while certain health problems (e.g. culture-bound syndromes) are difficult to understand using imported biomedical models from the West, they are readily understood within the cultural societies where they are manifested. The crux of this course is to examine mental illness, their manifestations, diagnosis, treatment and prognosis in different cultural societies.
The following areas of topics will be addressed during the 5-days of lectures.
• Culture and mental illness: Concepts, issues, models and theories
• Classification/grouping of mental disorders in diagnostic manuals: culture and methodology

• Review of some common mental illness (anxiety, mood, somatoform disorders and schizophrenia from a cultural perspective

• Culture-bound syndromes, cultural validations and their possible links with mental illness in the classification manuals

• Migration, Acculturation, Multicultural health

Cross-cultural and multicultural psychotherapy: Help-seeking behavior, treatment and prognosisA detailed description is expected.
Methods:
• The course will involve formal lectures, interactive group discussions and debates

• The students will do a lot of reading and self-reflection on mental disorders from their own society

• Discuss and interview people from other cultures how mental disorders are defined, identified and treated in their particular society

• Debate on whether modern day society is over-pathologizing everyday behavior

• Assignments to facilitate reading and discussion

The five main bullets under Point 14 – Contents -- above will constitute the major topic for each of the 5 days of face-to-face contact:

• Teaching will be interspersed with the teaching

• A debate will be planned for the 3rd teaching day

• Oral (group) presentation will be planned for the last day
Prerequisites:
Good working knowledge of English (TOEFL score of at least 550 points paper-based or 213 points computer-based, or an equivalent approved test). Students admitted to a Master’s Degree Programme may join this course (e.g. tropEd network.
Attendance:
Maximum number of students: 40
Selection:
Priority:
Master students enrolled at the University of Bergen
Students MSc in Int Health
Other tropEd students
Medical students at the University of Bergen
Fees:
€50 for students outside the University of Bergen, to cover administrative cost. In addition, the students need to register at the University of Bergen and pay the semester fee of approximately NOK 500 (subject to change)
Scholarships:
None
Major changes since initial accreditation:
The one major change that has occurred since last accreditation was to reduce the number of papers to be focused on in one assignment. The students complained that the amount of work involved was too much.

This course used to be run together with a similar course offered to psychology students at the University of Bergen (i.e., PSYK 302g). Because of major differences in educational backgrounds between the psychological students and the students following this course, the two courses are now run separately.

This course is now a 4ECTS.

There is presently no direct oral presentation, but in this revised course, an oral presentations together with a class debate on a topic such as culture vs. biological perspectives on mental illness; and whether mental illness is an over-patholagization of everyday hassles
Other than issues relating to student participation, the other major change planned is to link the course to the DSM 5. Currently the course is very much liked to earlier versions of DSM ICD classification systems. With the issue of DSM 5, the course will try and integrate this new diagnostics manual into it
Student evaluation:
The course does not attract the largest number of students, thus, it is easy to have close interaction with each other. It also makes it easy to place emphasis on areas the students are most interested in; feedback and evaluation of the course is spontaneous and informal
Lessons learned:
In inviting students to pick a mental health problem and discuss the cultural dimensions has expanded the lecturer’s own knowledge level of cultural aspects of mental illness
tropEd accreditation:
accredited Amsterdam/Copenhagen 2003; Re-accredited in May 2010 in Mexico, in February 2017. This course is valid until February 2022.
Remarks:
No compulsory reading will be assigned to the course. A couple of textbooks are however highly recommended:

1. Bhugra, D., & Bhui, K (eds). (2007). Textbook of cultural psychiatry. Chapters 1, 4, 5, 7, 8, 10, 11, 16, 17, 24, 26 – 33; Cambridge: Cambridge University Press.

2. Cromby, J., Harper, D., & Reavey, P. (2013). Psychology, mental health and distress. London: Palgrave McMillian

3. Tseng, W-S (2001). Handbook of cultural psychiatry. Chapters 9 - 11, 13, 14, 15 – 19, 31 32 San Diego: Academic Press.
Two Desk reference books

1. American Psychiatric Association (2013). Diagnostic manual and statistical manual of mental disorders 5th edition (DSM 5). Washington: APA.

2. World Health Organization (1990). International classification of diseases- 10 for the classification of mental and behavioral disorders. Geneva: World Health Organization; and A number of journal papers will all be suggested and revised from year to year.
Email Address: Linda.Forshaw@uib.no
Date Of Record Creation: 2018-10-18 09:57:00 (W3C-DTF)
Date Of Record Release: 2019-10-21 14:39:29 (W3C-DTF)
Date Record Checked: 2018-10-18 (W3C-DTF)
Date Last Modified: 2019-12-13 09:23:57 (W3C-DTF)

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